A debt ceiling battle looms over Medicare, Medicaid

Illustration of a red cross with the shadow of the hammer looming

Illustration: Sarah Grillo / Axios

House Republicans don’t have much way to pass major health care changes with a Democratic Senate and the president, with one possible exception: fighting the debt ceiling.

why does it matter: It’s not clear what spending cuts House Republicans will pay for expanding the government’s borrowing authority later this year — but some at least say health care programs like Medicare and Medicaid should be on the table.

  • Others, realizing how the mere talk of entitlement cuts has had political ramifications, say they want to stay away from the programmes.

what are they saying“We have to look at the entire board,” conservative Rep. Barry Loudermilk (R-GA) told Axios, including on mandatory spending like Medicare and Medicaid. “The easiest place to start with is discretionary, but the main driver of the national debt is mandatory.”

  • He added, “Everything is on the table.”
  • Asked about entitlements reform, House Speaker Kevin McCarthy told reporters Thursday that “as Republicans, we will protect Medicare and Social Security,” but he did not elaborate. (Nor does it mention Medicaid).
  • He added, “We will protect that for future generations, but we will examine every dollar spent.”

what do you want to watch: Rep. Morgan Griffiths (R-VA), who is a member of the Freedom Caucus and also sits on the Energy and Commerce Committee, said any changes to Medicare would not happen immediately.

  • “Anytime we talk about those wounds, people always panic,” he told Axios. “Nobody needs to panic. If we’re going to do something, it’s going to be far in the coming years and people will understand it and they’ll have time to adjust to it.”
  • He cited raising the eligibility age for Medicare from 65 to 67 as a possible change, while keeping it lower for people who have manual labor occupations and have trouble staying employed later in life.

Reality checkThe chances of any kind of major entitlements reform remain remote in a divided government. But if one thing is clear so far about the House of Representatives this year, it’s that it can’t be predicted.

  • Republicans say they will push for some kind of spending cut as part of the debt ceiling debate.
  • “I don’t expect that at all,” said Rep. Byron Donalds (R-Fla.), who at one point last week was an alternate candidate for GOP chairman of the anti-McCarthy faction, when asked about Medicare or Medicaid changes in debt-ceiling talks.
  • Rep. Brett Guthrie (R-KY), expected to be chairman of the House Energy and Commerce Health Subcommittee, said he’s interested in bringing back the controversial GOP plan from the debate over repealing the Affordable Care Act. It would limit Medicaid spending, saying the program must be “sustainable.”

  • He said he did not discuss including that plan in debt reduction talks. “I’d like to do it somewhere, I’m not sure we’d do it within debt.”

the other side: Democrats are already attacking and portraying the Republican Party as reckless.

  • “We intend to stand up for Social Security and Medicare and do the responsible thing and raise the debt ceiling,” Rep. Richard Neal (D-Mass.) told reporters. “The debt ceiling should not be held hostage to this kind of conversation.”
  • Moderate Republican Representative Dave Joyce (R-Ohio) acknowledged that some members of his party would introduce entitlement changes as part of debt-ceiling talks, but noted the changes would never make it through the Senate, calling them “ambitious.”
  • “This is a great soundtrack [where Democrats] It could throw us all under the bus in the campaign, but that doesn’t indicate what’s really going to happen at that time.”

A version of this story was initially published Axios forefront. Get news like this by subscribing. Use the code Politics 100 Which gives you a $100 discount.

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